Instrument for treating urethritis



o. HAYES INSTRUMENT FOR TREATING URETHRITIS Oct. 11,1921 1,644,919

Filed March 8. l9 26 /Z0 g; j/ 76; 2 M5 L9 /7' INVENTOR. OscafrhfirrsPatented Oct. 11, 1927 UNITED STATES osoAR HaYEs, or Axaomonio.

.msmmmmimn TREATING URETHRiTISr Application fil d March 8, i1926.":Seria1 No.93,060.

I This invention relates to instruments for treat ng urethr tis andcondltions resulting therefrom. o ,i

i. 4 ln chronicui-ethi'itis the pathologic lactors that are most.important in explaining the persistency offthe disease are str cture,

' I congested and granularpatches,enlargement and inflammation of 'thelacuna magna', 1a-

, -cuna of urethifa and the urethral finucuous o i,

follicles.

The chiefsourceof the discharge the fmucuons folliclesofthe urethra"involved in the chronic nflammation and granular large this meatus,by'iperiormlng a slight h patchesalong the flfifobi of the, urethra, and

frequently situated immediately behind'the 'strictured areas; i i

' Stricture ofH diminutionlof its caliben temporary or permanent. Thetype I of stricture inost fre- M y and inflammation resulting from abacter'ial' infection.

quently nietQWith inthe treatment of'c'hronic urethritis has been causedby the congestion Some ofithe procedures employed "surgeons intreatingfthe' aboveconditionsare:

- the use of 5 metal sounds, silk orT rubber .bougies and mechanicaldilators. These inf struments arejcylindric al in shapeand have i asmooth surface and their action is'to spread and Idilate the tissues,'The result. being that the strictures by gradually in-' i ,lcreasingth'ediameterofthesounds, bougies" or dilators from timetotimeare stretched and graduallyienlarged to the normal ,c ali-l ber oftheurethra, thus thelstric'tured area ,lS eventually corrected. However,this procedure is'frequently veryfpainfuland at n times the tissuesare'torn' and lacerated and torn areas have healed.

bougies ordilatorsare used for the purpose of stretching or emptyin'gthelacuna and urethral follicles; particularly the latter the" action isincomplete, as it is obvious that when the canal is stretehed'tocapacity the mouths or openings to the follicles are closed have takenplace. In introducing:

before the complete emptying of the pockets 7,

. of pushing theinfection further down to he urethra is'an 'abnormal l v4 'nstruments or the cylin- 'drical'type into the urethra there'isdanger 7 Mechanical dilators act very much the same as'the sounds orbougies only'thatthey are faster in their action, more painful to "thepatient, and are liableto domore damcent of cases is larger than theopening of I I themeatus, and it becomes necessary to enoperation; topermit I the introduction of I sounds or bougiesof suficientdiameter. VThe present invention contemplates the application of a principle tourethral instrumentsvvhich is unique and has not heretofore been usedTtis proposed to construct sounds and bougies and catheters along thesame generallinesthat are now in "use, only that the surface, instead ofbeing cylindrical, has a spiral raised area beginning Irom its tipandextendinga part Way "or the entire length of the instrument. In, otherWords, the body of the instrument will" consist of a shaft, the spiralscovering the body of the instrument. These spirals are 'conveXed,'smoothed and rounded to permit easy introduction Without doing anydamage to'the'tissuel. I The spiral metal sound is more easily'in-otroduced into a strictured" urethra than than eitherjstraight or curvedmetal sounds,

.silkor rubber bou'gies of the smooth cylin- V.

r type. The actionvof theinstrument' My with only a slight rotary motionproduced treatment necessarily has to'ceaseunt l the by theoperator-causes itto worm itsWay vinto thecanal'towardsthe bladder." TheWhen the cyli drical: type of sounds "body or shaft of the spiral soundcan befof a small diameter and the. spirals can be of differentelevations v on different instruments thus permitting a sound of alarger effective diameter'to be introduced through a stricwithouttearing the tissues than with the old type of instruments.When'thespiral sound is introduced into the urethral canal the operatormay grasp I ture with less tension; painor damage, and

the instrument, holding it firmly, preventing' the instrumentrotatingWhen it is Withdrawn sothat by thespirals passing over the stricturear'ea' every'portion of the stricv ture Will be massaged by theprogressive tion is produced which causes regeneration,

and a healthy normal condition of the tissues is thereby obtained.I'Vhenit is desired to empty the urethral follicles, the spiral actionon introduction, as well. as withdrawal, has a tendency to completelymilk out and empty the follicles because the pressure begins at thebottom of follicles leaving the mouth unobstructed,

action withdraws all material found in the thus permitting thefollicular contents to come to the surface of'the follicles. 20:

A spiral bougie of flexible material will have the same action as thestraight or rigid type, and will also pass through the curved portion ofthe urethra, enabling the operator to obtain the same results in theprostatic urethra, as well as the pendulous portion of it.

V A catheter constructed along the lines of thoseformerly in use, onlywith the spiral elevations, secures the same general benefit off thespiral bougies'for it will find its way through the urethral canal mucheasier than the old type. It is possible to introduce a spiral catheterthrough the urethra into the bladder where the cylindrical type willfail to enter, particularly in those patients with an enlargement of'theprostate gland.

The danger ofpushing infected substances, fluid or pus into the urethraby the spiral sounds, is much less than With the other type of urethralinstruments... The spiral urethra out towards the meatus or outside,where the other types of instruments will a push these materials orinfections inward toward the bladder.

Since the shaft or barrel of the spiral sound, bougie or catheter issmaller than the outside diameter of the spiral surface, it is possibleto introduce much larger spiral instruments through a contracted meatusthan with the old cyl1ndr1cal type. For example, a meatus which Wlllpermit the 1n- .troduction of an instrument no larger than 7'formsthereof as shown and described below.

Of the accompanying drawings, Figure 1 illustrates a diseased urethralcanal;

Figure 2 illustrates. a metal sound, embodying and adapted to' carry outthe invention, in said canal; and

Figure 3 illustrates a flexible catheter embodying the invention.

Referringtothe'drawings, 10 represents a diseased urethral canal having,for example, congested and granular -patches as indicated at 11 and astricture as indicated A metallic sound embodying the invention is showngenerally at 13 (Figure 2) and comprises a cylindrical shank 14 having araised spiral rib l5 thereon extending from a comparatively blunt end 14to a point spaced from a handle 16' sufficiently to permit working ofthe spiraled' portion of the instrument held against rotation back andforth entirely within the canal so 'as not to cause needless pain. Thesurface of rib 15 is convex or rounded and smooth so as to massage thewall of the canal without lacerating the tissues. The handle 16 ispreferably of suitable shape in section (hexagon shape, for example) soas to facilitate rotation of the instrument by the hand and also tofacilitate holding it against rotation. The instrument is of such lengththat it may be worked well into the urethral canal toward the bladder.

In Figure 3 a catheter 17 is shown. This comprises a flexible hollowtube 18 of material such as rubber having a spiral rib 19 thereonsimilar to rib 15. The entering end of the catheter has the usualaperture 20 therein. The body portion of the instrument, however, issmooth and imperforate so as not to injure the tissues.

It is, of course, to be understood that the sounds, bougies or cathetersmay be of rigid or flexible material and either solid or hollow. Inevery case, however, they are formed with spiral ribs, suchas 15 or 19,to secure the benefits of the invention.

In practice, the canal 10- to' be treated is preferably first filledwith a suitable lubricating, non-greasy, mildly antiseptic jelly, suchas boric acid jelly. The instrument, preferably similarly lubricated, isthen introduced into the canal by forcing it inwardly while rotating.Due to the formation of the instrument this is easily accomplished witha minimum of pain since the perimeter of the instrument at any point isless than the circumference of an equivalent cylindrical instrument.

The spiraled portion of the instrument is entirely introduced (Figure 2)in the above manner. The wall of the canal is then massaged by theinstrument by holding it against rotation and moving it back and forth-The massaging and dilating action of the spiral rib on the wall of thecanal at any point, for example, at the stricture 12, is progressivelyand rotatively about the normal caliber of the canal. This massagingaction on the follicles thoroughly milks them of the pus. It will beseen that under this action of the spiral rib when entering,

the tendency to carry the pus back into the bladder is obviated, andupon Withdrawal of i the instrument, the pus that has been massaged fromthe wall of the canal will be effectively Withdrawn. i Modificationsofthe invention may be resorted to without departing from the spiritthereof or the scope of'the appended claims. a

What is claimed is: I v

1. An instrument comprising flexible shank of uniform diameterandimperforate throughout the body portion thereof formed with a closedenteringend and having an aperture therein adjacent said end, said shankhaving a fixed, spiral, roundt ed ribof uniform height on the bodyportion thereof.

2. An instrument for treating urethritis comprising a flexible shank ofuniform diameter and smooth throughout the body portion thereof andformed throughout said body portion with a fixed continuous spiral ribof uniform height, said rib being smoothand rounded. 1 3. An instrumentfor treating urethritis,

said instrument comprising a shank of uniform diameter slightly taperedor rounded at its entering end and smooth throughout its body portionand having, a handle on one end and formed with a fixed continuousrounded spiral rib of uniform height extending from a point spaced fromsaid u o r handle to the entering end of said shank.

a hollow 4. A sound, bougie or the like, comprising a V cylindricalshank of unlform diameter throughout the length of its dilating portionand having a smooth surface on said dilating portion on which is raiseda fixed continuous splral rib.

OSCAR HAYES.

